Objective To assess the efficacy of an innovative operational management model in enhancing the refined operational management of a public hospital.Methods An innovative operational management model,"One Body,Two Wings and Three Drives",was developed,which involved establishing a systematic operational management system,strengthening per-formance and cost control,and reinforcing the supporting roles of discipline construction,scientific and technological innovation,and smart hospital initiatives.This comprehensive approach aimed to systematically promote hospital operational management re-forms and improve overall efficiency and quality.Results After using this model,the hospital presented continuous improve-ments in operational efficiency and medical quality,with key performance indicators trending positively.Over the past three years,the average annual growth rate of outpatient and emergency service visits reached 6.6％,inpatient service visits increased by 5.7％,and the Case Mix Index(CMI)rose by 0.22 over two consecutive years.Conclusion This model is highly systemat-ic,practical,and policy-compatible,providing a replicable path for the high-quality development of public hospitals.

ObjectiveTo explore the effects of the Tibetan medicine Sanwei Doukoutang （SWDK） on cognitive dysfunction in mice suffering from Alzheimer's disease （AD） and its related mechanism. MethodsFifty SPF 5 × FAD mice were randomly divided into model group， total ginsenoside group（0.04 g·kg^-1）， high-， medium-， and low-dose groups of SWDK （32.60， 16.30， 8.15 g·kg^-1）， with 10 mice in each group， and ten wild-type mice of the same age were used as the normal group， male and female in 1∶1. Gavage administration was performed once daily for 8 weeks. The Morris water maze test and contextual fear memory experiment were used to observe learning and memory function. Hematoxylin-eosin （HE） staining was utilized to observe the changes in the pathomorphology of brain tissue in mice. The levels of synaptophysin （SYP） and postsynaptic dense substance 95 （PSD95） in mice serum were detected by enzyme-linked immunosorbent assay （ELISA）. The positive expression of brain-derived neurotrophic factor（BDNF） in the dentate gyrus （DG） region of mouse brain tissue was observed by immunohistochemistry （IHC）. The protein levels of BDNF， Wnt family member 3A（Wnt3a）， and β-catenin were detected in the hippocampus of mice by Western blot. ResultsCompared with the normal group of mice， the model group of mice had significantly more complex swimming routes and lower swimming speed （P<0.01）， significantly lower percentage of time spent in the target quadrant （P<0.01）， and a significantly lower percentage of freezing time （P<0.05）. The number of neurons in the hippocampal region of mice was obviously reduced and unevenly arranged. The levels of SYP and PSD95（P<0.01） in the serum of mice were reduced， and the positive expression of BDNF in the DG region of the brain tissue of mice was reduced. The levels of hippocampal BDNF， Wnt3a， and β-catenin proteins in the hippocampus of mice were obviously reduced （P<0.05， P<0.01）. Compared with the model group， the mice in the SWDK group and the total ginsenoside group had significantly shorter swimming routes， the high- and medium- dose SWDK groups significantly higher swimming speeds （P<0.01）， significantly higher percentage of time spent in the target quadrant （P<0.01）， obviously higher percentage of Freezing time （P<0.05）， and obviously more neurons in the hippocampal region of the mice with tighter arrangement. The mice had elevated levels of serum SYP （P<0.05， P<0.01）， PSD95 （P<0.01）， increased BDNF-positive cells in the DG region of brain tissue， and obviously elevated levels of BDNF， Wnt3a， and β-catenin proteins in the hippocampus of mice （P<0.05， P<0.01）. ConclusionSWDK can significantly improve the cognitive dysfunction of AD mice， and its mechanism may be related to regulating the Wnt/β-catenin signaling pathway， which promotes BDNF expression and thereby enhances synaptic plasticity， allowing neuronal signaling to be restored.

ObjectiveTo explore the effects of the Tibetan medicine Sanwei Doukoutang （SWDK） on cognitive dysfunction in mice suffering from Alzheimer's disease （AD） and its related mechanism. MethodsFifty SPF 5 × FAD mice were randomly divided into model group， total ginsenoside group（0.04 g·kg^-1）， high-， medium-， and low-dose groups of SWDK （32.60， 16.30， 8.15 g·kg^-1）， with 10 mice in each group， and ten wild-type mice of the same age were used as the normal group， male and female in 1∶1. Gavage administration was performed once daily for 8 weeks. The Morris water maze test and contextual fear memory experiment were used to observe learning and memory function. Hematoxylin-eosin （HE） staining was utilized to observe the changes in the pathomorphology of brain tissue in mice. The levels of synaptophysin （SYP） and postsynaptic dense substance 95 （PSD95） in mice serum were detected by enzyme-linked immunosorbent assay （ELISA）. The positive expression of brain-derived neurotrophic factor（BDNF） in the dentate gyrus （DG） region of mouse brain tissue was observed by immunohistochemistry （IHC）. The protein levels of BDNF， Wnt family member 3A（Wnt3a）， and β-catenin were detected in the hippocampus of mice by Western blot. ResultsCompared with the normal group of mice， the model group of mice had significantly more complex swimming routes and lower swimming speed （P<0.01）， significantly lower percentage of time spent in the target quadrant （P<0.01）， and a significantly lower percentage of freezing time （P<0.05）. The number of neurons in the hippocampal region of mice was obviously reduced and unevenly arranged. The levels of SYP and PSD95（P<0.01） in the serum of mice were reduced， and the positive expression of BDNF in the DG region of the brain tissue of mice was reduced. The levels of hippocampal BDNF， Wnt3a， and β-catenin proteins in the hippocampus of mice were obviously reduced （P<0.05， P<0.01）. Compared with the model group， the mice in the SWDK group and the total ginsenoside group had significantly shorter swimming routes， the high- and medium- dose SWDK groups significantly higher swimming speeds （P<0.01）， significantly higher percentage of time spent in the target quadrant （P<0.01）， obviously higher percentage of Freezing time （P<0.05）， and obviously more neurons in the hippocampal region of the mice with tighter arrangement. The mice had elevated levels of serum SYP （P<0.05， P<0.01）， PSD95 （P<0.01）， increased BDNF-positive cells in the DG region of brain tissue， and obviously elevated levels of BDNF， Wnt3a， and β-catenin proteins in the hippocampus of mice （P<0.05， P<0.01）. ConclusionSWDK can significantly improve the cognitive dysfunction of AD mice， and its mechanism may be related to regulating the Wnt/β-catenin signaling pathway， which promotes BDNF expression and thereby enhances synaptic plasticity， allowing neuronal signaling to be restored.

Objective To assess the efficacy of an innovative operational management model in enhancing the refined operational management of a public hospital.Methods An innovative operational management model,"One Body,Two Wings and Three Drives",was developed,which involved establishing a systematic operational management system,strengthening per-formance and cost control,and reinforcing the supporting roles of discipline construction,scientific and technological innovation,and smart hospital initiatives.This comprehensive approach aimed to systematically promote hospital operational management re-forms and improve overall efficiency and quality.Results After using this model,the hospital presented continuous improve-ments in operational efficiency and medical quality,with key performance indicators trending positively.Over the past three years,the average annual growth rate of outpatient and emergency service visits reached 6.6％,inpatient service visits increased by 5.7％,and the Case Mix Index(CMI)rose by 0.22 over two consecutive years.Conclusion This model is highly systemat-ic,practical,and policy-compatible,providing a replicable path for the high-quality development of public hospitals.

The high-quality development requirements for public hospitals,national examination orientations,and DIP medical insurance payment reforms present significant challenges to the refined management of public hospitals.Therefore,it is essential to enhance the operational management of these institutions.This paper aims to develop an operation evaluation index system for clinical departments using the Delphi method for assessing the efficiency of resource input and output across various clinical departments.It provides a scientific basis for decision-making regarding resource allocation,transformation towards re-fined management,and the enhancement of operational guidance for departments.

ObjectiveTo explore the influencing factors of health seeking behavior of delivery women in Guangdong province.MethodsStratified random sampling method was used,and 1491 delivery women from primary,secondary and tertiary hospitals were investigated with self-made maternal health seeking behavior questionnaire.Logistic regression analysis was used to analyze the impact of environmental factors and population characteristics on health seeking behavior.ResultsDelivery women with qualified health seeking behavior account for 83.4%.Present pregnancy was planned (OR=2.114),prenatal examination was needed when self-feeling good (OR=2.323),social medical insurance system was socialized medicine (OR=2.755) or medical insurance (OR=1.697),hospital level of secondary hospital (OR=1.568) or tertiary hospital (OR=1.800) were independent positive influencing factors of health seeking behavior.ConclusionThe qualified rate of health seeking behavior of delivery women in Guangdong province is low.Delivery women with the following characteristics of low educational level,low family income,uninsured,coming from rural area and delivery in primary hospital need to be guided scientifically at seeking for health.

Chronic non-communicable diseases have become one of the public health problems threatening human health.Management measures of chronic diseases were summarized,such as three level prevention and self-management of chronic diseases,and patient joint decision-making.Behavioral interventions on chronic diseases were also summarized,such as risk factors of chronic disease,information technology and telemedicine.It suggests that a variety of chronic disease management and behavioral intervention measures should be applied in practical work to improve the patient compliance while enhancing the prevention and treatment of chronic diseases.

The standardized resident training is an important part of continuing medical education in China,which plays a vital role in the cultivation and development of doctors.At present,the standardized resident training system in our country is at an exploratory stage and different from those advanced countries.This paper contrastively analyzed the domestic and foreign standardized resident training modes from the perspectives of education patterns,training years,training organizations,training contents,assessments,and financial sources.By learning from the advanced experience of those foreign countries,it provided the reference for the standardized resident training system in China.

Objective To establish the evaluation index system on maternal health seeking behavior with Delphi method.Methods Based on Andersen health service utilization models,literature analysis was used to establish evaluation index system on maternal health seeking behavior,then Delphi method was carried out to revise index system through two rounds questionnaire consulting from 24 experts.Results The confirmed index system of maternal health seeking behavior included 4 first-level index,12 second-level index and 57 third-level index.The average authority degree of experts were 0.869,and the coordination coefficients of expert in the total index were 0.195 and 0.166(P＜0.01).The weight coefficients of the indicators at first level were 0.1529,0.3403,0.2786 and 0.2281,respectively.Condusion The representativeness,authority degree and coordination of expert are good,and the tentatively established evaluation index system on maternal health seeking behavior is scientific and reasonable.

Objective To investigate the association between depression and clinical outcomes in elderly patients undergoing percutaneous coronary intervention (PCI).Methods Four hundred and fifty-one patients aged ≥ 60 years undergoing PCI in cardiovascular department of Anyang People's Hospital from January 2012 to June 2014 were prospectively analyzed in this study.Patients were divided into PCI without (SDS＜50) and with (SDS≥50) depressiongroup.They were tested by the self-rating depression scale (SDS) at discharge,and followed up for 1 year.And the 1-year mortality was compared between two groups.Multivariable Logistic regression analysis was used to confirm the independent risk factors for the 1-year mortality.Results The 1-year mortality was higher in PCI with depression group than in PCI without depression group (8.9oo vs.3.9％,P=0.035).As compared with PCI patients without depression,PCI patients with depression showed the increased odds ratio (2.55,95％ CI:1.05 ～ 6.17,P=0.039) for 1-year mortality by multivariable Logistic regression analysis.Conclusions Depression is an independent predictor for mortality in elderly patients undergoing PCI.